Never That Simple
by annonwrite
Summary: Sam thinks he pulled a muscle. Unfortunately for the Winchesters, it's never that simple.
1. Chapter 1

**Author****'****s ****Note:** Someday I will stop being mean and making the characters I love sick, hurt, miserable, etc. But don't worry. That day is not today.

* * *

><p>They've been in the car for 17 hours. Lancaster, PA to Minneapolis, MN, or thereabouts. Sounds like an angry spirit, a simple salt and burn. But the thing is moving fast, and they've gotta be faster.<p>

Dean drives all day, stopping only when the gas tank is on E. Normally, Sam doesn't mind long car rides. Practically grew up on them. But lately he's got restless leg syndrome or some shit, and he just wants to stretch his legs. "Are we almost there?" he asks, then winces when he realizes how bad that sounded.

Dean shoots a corner-eyed glance in his direction. "What are you, five years old?"

Sam ignores the question and tries to stretch, wishing he would have stopped growing about a foot ago.

* * *

><p>It turns out to be one of the fastest and easiest hunts they've had in a while. The only snag they hit is when Sam pisses the spirit off and gets tossed against a tree right before the bitch goes up in flames.<p>

"You okay?" Dean asks, wiping his hands on his jeans as he walks over.

Nothing feels broken. Sam grunts and accepts Dean's outstretched hand to help him up. "That was fast."

"We're just getting too good at this, Sammy."

* * *

><p>The next morning, Sam winces when he gets out of bed. His back feels bruised and there's pain in his right calf.<p>

"You limping?" Dean asks as Sam makes his way to the bathroom.

"That tree," Sam says vaguely, waving it off. No big deal.

Dean's got a newspaper spread out in front of him. "Looks like there might be something near Madison, Wisconsin. A bunch of people gone missing."

Sam limps the rest of the way to the bathroom. More time in the car. Another hunt for him to get tossed around in. Yippee.

* * *

><p>Two days later, they're near Madison, but this case is not nearly as straightforward as the last one. Sam's back is 100% better, but his calf is still bugging the hell out of him.<p>

"What's wrong with your leg?" Dean asks when he catches Sam massaging below his knee for the thousandth time.

"Pulled a muscle," Sam says.

Dean smirks. "Oh, Princess, you want me to rub it for you?"

Sam smacks Dean upside the back of his head and doesn't even feel bad about it.

* * *

><p>Two more days and Sam's not sure this is a pulled muscle anymore. It's getting worse, not better, even though they're doing more research and grasping at straws than actual hunting. Sam likes to think he has a pretty high tolerance for pain, but whenever they have to walk a long ways or stand for a while, his calf friggin aches. His foot and ankle are kind of swollen, too.<p>

"Dean," he starts at one point when he thinks he ought to say something about it.

Dean looks up from the book he's reading. "Yeah?"

But then Sam predicts Dean's reaction to a pulled muscle, up to and including calling Sam a "pansy-ass bitch" and telling him to suck it up. He changes his mind. "You, uh, find anything yet?"

"No. You?"

"No."

Dean turns back to his book and Sam turns back to the computer and rubs his leg.

* * *

><p>Three days later, they're heading to interview the family of the latest victim. Sam's sitting on the edge of the motel mattress, but either his right shoe shrunk or his foot is a lot more swollen than it was before. Sam stares down at his socked foot.<p>

"What's the hold up, Sam?" Dean asks, duffle bag slung over his shoulder, keys in hand.

"I can't get my shoe on."

There's a pause. "Seriously, Sam? I'm pretty sure I taught you that when you were still in diapers."

"My foot is too swollen," he says in lieu of a witty comeback.

"Shit." Dean drops the duffle bag and the keys. He crouches in front of Sam and gently tugs off the sock that's way too tight. "Did you twist it when you got tossed against that tree?"

"Don't think so."

Careful but sure fingers feel along the bones that are hiding beneath the swelling. Turn his ankle from left to right. "That hurt?"

"No." It feels a little tight because of all the extra fluid, but it doesn't hurt. That is, not until Dean flexes his foot up towards his shin and pain explodes all the way up to his calf. "Fuck," he hisses.

"That?" Dean asks, and Sam wants to punch him when he flexes the foot again, just to be sure.

"My calf," Sam groans, clutching at the muscle there.

Dean frowns and narrows his eyebrows. He forces the pant leg of Sam's jeans up to his knee, runs his hands over shin and calf. Then he pushes up the other pant leg as well.

"If you're trying to feel me up or something…" Sam starts, but doesn't get very far before dean interrupts.

"Your whole damn leg is swollen."

Sam looks down and compares leg to leg. Huh. Shit. It is.

"You get bit anywhere?" Dean asks, checking the right leg again.

"Don't think so."

"I don't see anything. Nothing seems broken." Dean stands and walks over to the duffel bag. Riffles around until he finds a bottle of Ibuprofen. Shakes three out of the bottle and hands them to Sam. "Can you walk?"

Hurts like a bitch, but yeah. He can walk. "Yeah."

Dean hefts the duffle bag back up. "Come on. We'll hit the ice machine on the way out. You can ice it in the car."

Sam dry-swallows the pills and limps out of the motel room with one bare foot, extra boot and sock in his hands.

They're going to need a fucking big bag of ice.

* * *

><p>The next day, Sam's boot is on only because he took the lace out completely, and even then it's still on the uncomfortable side of tight. The pain is worse, but he doesn't tell Dean because it's just a pulled muscle. Just a pulled muscle that's practically bringing him to tears with every slow, limping step.<p>

They're stopped for lunch when Dean says, "Scale of one to ten?"

Sam sighs over his bowl of soup. "Eight."

Dean's hazel eyes look concerned when he hears the number usually reserved for bullet wounds and open fractures. "Maybe we should get it checked out."

"Yeah. Maybe."

* * *

><p>A few hours later, Sam is sitting on a hospital bed in the ER, wondering why they made him change into a gown when he's just got a pulled muscle. Dean is sitting in the chair next to the bed, holding Sam's clothes and boots – one with a lace, one without.<p>

"Don't dick around, okay? Tell him how bad it is. Get them to give you the good drugs for whatever it is."

Sam nods and looks up as a doctor walks in.

"Sam Rodriguez?"

Sure, why not? "Yes, sir."

The doctor is graying and balding, but has a kind smile when he shakes Sam's hand. "I'm Dr. Roberts." He turns to Dean.

"Dean Rodriguez. His brother," Dean says.

"What seems to be the problem today, Mr. Rodriguez?"

Sam shows the doctor his swollen leg. Explains the pain. Answers the obligatory questions.

"This hurt?" the doctor asks before flexing Sam's foot like Dean did before, like he already knows it's going to hurt.

"Yes," Sam hisses, bunching the bed sheet in his fists.

"Easy," Dean says, patting Sam's arm. "Relax."

Sam tries, but fuck, that hurt.

"Sorry," the doctor says. "Have you experienced any shortness of breath? Coughing? Chest pain?"

Even though Sam says no, the doctor spends way too long listening to Sam breathe for someone who came in with a leg injury.

"What do you think, doc? Gonna get some x-rays?" Dean asks as the doctor puts his stethoscope back around his neck.

"Possibly." He jots something down on a clipboard. "First I'm going to send you for an ultrasound."

"Hey, isn't that what pregnant chicks have?" Dean asks.

The doctor smiles. "That's one of the uses, yes. But this will be an ultrasound that shows the veins in Sam's leg. Make sure there are no circulatory problems. I'll put the order in now. Transport should be here to take you to radiology soon."

Sam nods. "Thank you." Once the doctor is gone, Sam flops his head back against the bed and turns to Dean. "Before you get any bright ideas, you are not coming with me."

"Wrong. I'm totally coming with you. I want to see if the baby's going to be a boy or a girl."

"Dean…"

"What? Is the baby kicking? Did your water break?" He's so amused by himself that there's actually a twinkle in his eye.

"Fucker," Sam says. But he smiles just a little.

"Shouldn't talk like that, Sammy. The baby might be able to hear."

Before Dean can fire off any more pregnancy jabs, someone from transport arrives. "Ready to go for your ultrasound, Mr. Rodriguez?"

Dean stands and sets Sam's clothes down. "You bet we are."

* * *

><p>The radiology technician squirts warm gel onto Sam's leg, up near his groin.<p>

"See, Sammy?" Dean asks. "Told you they're looking for a baby."

The technician laughs. "Sure," she says. "Just hold still, okay, Sam? This shouldn't take too long."

She presses the wand to Sam's leg, and a mess of black and white lines and shapes appear on the screen. She inches the wand down Sam's leg, stopping every few seconds to press buttons on the machine or squeeze Sam's leg in different places.

A lot of weird noises come from the machine's speakers, and Sam doesn't know whether to be impressed or grossed out that he can see and hear what's going on in his body.

"Are you sure there's not a baby in there?" Dean asks, squinting at the screen.

"Yes, Dean," Sam deadpans. "There's a baby in my thigh. That's why my leg has been swollen."

Dean flips Sam off, but the technician just laughs again. "I know it doesn't look like much, but once you understand what you're looking at, it can tell you a lot."

"If you say so," Dean says, shaking his head.

The technician continues working, moving the wand down to the side of Sam's thigh, almost to his knee. She squirts more gel on his leg and flips to the back of his knee, down his calf. Every time she presses down now, Sam winces.

"I'm sorry. Does that hurt?"

"It's okay," Sam says even though it's not.

"Almost done. How long has your leg been swollen?" she asks.

"About a week."

"Have you had any shortness of breath?"

"Why do people keep asking him that?" Dean snaps. "It's his leg that's the problem, not his lungs."

"Dean," Sam admonishes. "No. I haven't had any shortness of breath."

"Good," the technician says. But when she smiles at him this time, he swears he sees sympathy on her face. What the hell is wrong with him? She turns off the machine. "I'll show this to the radiologist. Transport will be here soon to take you back to the ER, and Dr. Roberts should be back with you shortly."

"What is it? What did you see?" Dean asks.

"I'm just the technician. Dr. Roberts will be able to tell you soon." The way she says it indicates that she definitely saw something wrong.

"Fuck," Dean mutters once she's gone, rubbing a hand over his face.

Sam would have preferred a pregnancy joke.

* * *

><p>"Well, Mr. Rodriguez, I'm afraid I don't have the best news," Dr. Roberts says.<p>

"Okay," Sam says. He sees Dean tense in the chair next to his bed.

"You have an occlusive deep vein thrombosis in the right popliteal vein."

"English, please," Dean all but growls.

"A blood clot, which is also called thrombus, is completely blocking the deep vein behind your knee and into your calf. It's a fairly significant clot."

"But…that's not serious, right?" Even though he asked the question, Sam's not really sure he wants to hear the answer.

"As long as the clot stays in the leg, it's not significantly dangerous. However, if any part of the clot breaks off and travels to the lungs, heart, or brain, that could be a problem."

"Shit," Dean breathes.

And Sam nods, because yeah, dying could be a problem.

"You can give him a medication for that, right? Take care of the clot? Get rid of the pain? Send him home?" Dean asks.

The doctor gives a sympathetic smile. "Unfortunately, it's not that simple, Mr. Rodriguez."

And Sam should have known it wasn't a pulled muscle, because for the Winchesters or the Rodriguezes or whoever the hell they are, it's never that simple.


	2. Chapter 2

**Author****'****s ****Note:** Thanks for the comments and encouragement! Y'all make me a happy writer!

* * *

><p>The doctors aren't really sure why Sam developed a blood clot. It's got nothing to do with him getting thrown into a tree. Might have something to do with the ridiculous number of hours they spend in the car, sitting still for too long. But it's still unusual for someone as young and healthy as Sam, so they're running some tests.<p>

"Are you planning on leaving any blood in my body?" Sam asks as the nurse fills the 7th vial of his blood and switches it out for another empty vial.

"Haven't decided yet," she deadpans. But she's young and cute, so Sam lets it slide. He's been moved from the ER to a room upstairs because they need to get him medicated or observe him overnight or some shit. He just hopes they drug him soon because his leg is throbbing.

"So, these blood tests, they'll tell us why Sam got a blood clot?" Dean asks.

"Hopefully," the nurse says. "There. All done. Now I'm just going to start the IV."

"What is that?" Dean nods to the IV bag.

"Heparin. It's a blood thinner." She sets up the IV and adjusts the settings on the pump.

"That will get rid of the clot?" Sam asks.

She gives a little laugh. "Sorry, but no. Your body will get rid of the clot on its own, but you're going to be stuck with it for 3 to 6 months. The Heparin just reduces the risk of the clot breaking off and travelling to your lungs or heart, and lowers the chances of developing more clots."

"3 to 6 months?" Sam asks, looking at the IV in the crook of his arm.

"Relax," the nurse says, adjusting the tubing and patting his shoulder. "You'll only be on Heparin until you go home, probably tomorrow or the next day. Then you'll be on Lovenox, and this." She holds up a pill. "Your new best friend."

"What's that?" This time it's Sam's turn to ask.

"Coumadin. Another blood thinner. It takes about a week to become effective, though. Thus the Heparin." She pops the pill out of its foil packet and hands it to Sam with a Styrofoam cup of water. "Bottoms up." Sam swallows the pill and watches as she picks up another syringe. "Pain medication," she says before either one of them can ask what it is. "Good stuff." She pushes the syringe slowly into the IV port.

It doesn't take long for Sam to feel the effects. The throbbing pain in his leg backs off to a slightly annoying twinge. He relaxes into his pillows and sighs. "Good stuff," he echoes.

The nurse smiles and starts cleaning up her supplies. "Do you have to go to the bathroom?" she asks.

Sam lifts an eyebrow. "No. Why?"

"Because you're on complete bed rest until that Heparin kicks in. When you need me, just press the call button," she says, motioning to a button on the side of the bed. "I'll check on you in a little while."

As soon as the nurse is gone, Dean snorts. Sam holds up a hand to stop him. "Not one bedpan joke," he warns.

"Oh come on, Sammy," Dean laughs. "So many bedpan jokes. My head is going to explode."

"I know. That's why I'm warning you. Not one."

"You're no fun," Dean whines.

Sam sighs and turns on the TV. They settle in on an action movie, and Dean puts his feet up on Sam's bed.

"How's the pain?" Dean asks.

"Medicine helped," Sam answers. "I'm good."

"Good."

They watch the movie for a while. At one point, Sam eyes the distance between the bed and the bathroom. It's four feet away at best. If his arms were a little longer, he could reach out and touch it. Making an executive decision, he throws the blankets off his legs and slides to the edge of the bed.

"Where do you think you're going?" Dean asks, sitting up.

"Bathroom."

"Bed rest," Dean counters.

Sam reaches over and unplugs the IV pole from the wall.

"Sam, seriously, I know I was giving you a hard time about the bedpan earlier, but I don't want anything to happen to you…"

"Dean, if I'm going to die by walking from this bed to the bathroom, then at least I'll die with my dignity intact. Now, are you going to help me up or not?"

And Dean shuts the hell up and helps Sam with his IV pole, because really what is he going to say in response to that?

Sam limps to the bathroom and tries really hard not to die.

* * *

><p>"You good?" Dean asks.<p>

Sam nods. It's late and they just gave him pain medication to help him sleep, so yeah, he's good. "You should go," he says. It's been a long, boring day of watching the Heparin drip into Sam's veins.

Dean makes a "pfft" noise. "Go where? The motel? Don't think so." He puts his feet back up on Sam's bed and scoots down in the chair, tucking his hands behind his head. "I'm gonna sleep right here."

Sam's eyelids are heavy, so he lets them fall closed. "Dean?"

"Yeah?"

"Think I'm going to die?"

"Someday? Yes, Sammy. I think someday you're going to die."

Sam opens his eyes just long enough to give Dean a "you're not fucking funny" glare. "I mean today. Or tomorrow. Or," Sam waves a little with his non-IV arm, "because of this thing in my leg."

There's a pause. "No. I think you're going to kick the thing in your leg's ass. Just like we kick the ass of any other deadly thing we come across."

Sam nods but doesn't open his eyes. "Not worried?"

"Nope." Another pause. "Are you worried?"

"No," Sam says, but it's not as convincing as it should be.

"How's your chest? Trouble breathing or anything?"

"No," he says, confident this time.

"Good. Let me know if that changes, okay?"

Sam wants to say okay, but he's too damn tired. The last thing he's aware of is Dean's hand on his chest. And yeah, he's not so worried anymore.

* * *

><p>"So here's the deal," the doctor says early the next afternoon. This one's name is Dr. Khan. Sam's kind of stopped trying to keep them straight. "Your PT INR is still far too low, which isn't a surprise since you've only had one dose of Coumadin."<p>

"PT INR?" Dean asks.

"It's a measure of how thin the blood is. For patients on Coumadin, we like the INR to be between 2 and 3. Sam, your last blood tests showed an INR of 0.8."

Dean smirks. "That the first test you ever failed, Sammy? A blood test?"

Sam ignores Dean. The doctor ignores Dean. "Your INR should be within range in a week or so. You'll have to have your primary care physician check to make sure it's not too high or too low and they'll adjust your Coumadin dose accordingly."

"So if the INR is too low, I'll be at risk of more blood clots or a pulmonary embolism, right?"

"Correct," the doctor nods.

"What about if it's too high?" Dean asks.

"Bruising. Bleeding. Could include serious internal bleeding. It's important that you make sure your levels are in range. It's also important to be careful for the next 3 to 6 months while you're on Coumadin. No contact sports. No rough activities."

Sam and Dean exchange a glance because hunting probably qualifies as both a "contact sport" and a "rough activity."

"You'll have to watch what you eat, too," Dr. Khan continues. "Many vegetables can affect the INR. Especially green vegetables like broccoli, kale, and spinach."

Dean sounds almost giddy when he asks, "So, he can't eat vegetables? Burgers and fries are okay, but salads aren't?"

"It's okay to eat salads. Just make sure to eat them consistently throughout the week."

Dean's excited face falls. "Aw, man. Thought I was going to kick his health food habit."

"Not quite. The only thing you really have to stay away from on Coumadin is alcohol," the doctor says, like it's no big deal.

"No alcohol? For 6 months?" Dean asks, his eyes as wide as saucers. "Is that even possible?"

"Possible and important." The doctor turns to Sam. "No alcohol."

Sam sighs and nods. "So, okay, I have to have my INR checked, be careful, don't drink, and watch what I eat. But that's only once my levels are in the range, right? What about until then?"

Dr. Khan smiles. "That's your choice. You can stay here on the Heparin IV. Or I can prescribe injections of low-molecule weight Heparin. Lovenox. You would just have to give yourself a shot twice a day for the next week, or until your INR is in range."

"What do you think, Sam?" Dean asks. "Want to blow this popsicle stand?"

Sam nods. "Yes. Definitely."

"Good. I'll have a nurse take out that IV and bring your discharge papers. The blood tests to find out why you got the clot will be back in a few days. Someone will give you a call. Do you have any questions for now?"

"Yeah. When will my leg stop hurting?"

The look Dr. Khan gives Sam is not reassuring. "Could still be a few more weeks. I'll give you pain medication to take care of it until then, okay? And take it easy for the next week or two. Rest. Keep your leg elevated. Avoid walking around too much."

Weeks of pain? Rest? And no alcohol? Shit. "Yeah. Okay. Thank you."

"You're welcome. Take care. Watch out for any chest pain, coughing, or shortness of breath, okay? Go straight to the ER if that happens."

Sam nods and wishes people would quit bringing that up, because if something can go wrong for the Winchesters, it probably will.

Once the doctor is gone, Dean claps Sam on the shoulder. "Freedom, man. Want to go watch me drink a beer to celebrate?"

It's going to be a long 3 to 6 months.


	3. Chapter 3

**Author's Note:** More. Yay. Enjoy!

**Medical Cheat Sheet:**

DVT = deep vein thrombosis (nasty blood clot)

PE = pulmonary embolism (when nasty blood clot travels to lungs)

PT INR = Huh. I should know what that stands for, but I don't. It's the blood test that shows how thick/thin a person's blood his – how long it takes to clot.

* * *

><p>"Do you need me to do that for you?" Dean asks.<p>

Sam is reclining on the motel bed that's not much softer or cleaner than the ground. His jeans are slouched below his waist and his shirt is pulled up so he can see the mess of bruises that used to be his lower abs.

Instead of answering Dean's question, Sam finds an inch or two of skin that's maybe not quite as purple or green as the rest, cleans it with the alcohol swab, and jabs the needle in. He quickly injects the medication and removes the needle, snapping the safety cover into place. "Done," he says, then hisses because the stinging that follows the injection is worse than the injection itself.

Dean is sitting at the room's sorry excuse for a desk, typing away at Sam's laptop. "Such a big boy. Didn't even need me to hold your hand."

Sam just grunts, because damn, still stings.

"Did you know that something like one in three people with a DVT end up with a PE?" Dean asks.

"You gotta quit that."

"Quit what?"

"Reading health stuff online. That shit will make you crazy. Most of it's not even correct." The stinging is going away, so Sam zips and buttons his jeans, wincing when the denim comes in contact with the bruises.

Dean scoffs. "It's Web MD, Sam. It's like the medical professionals' Bible."

"Actually, it's more like Hypochondriacs Anonymous."

Dean turns and studies Sam. "But you're good? You're breathing's okay?"

If Sam had a nickel for every time Dean's asked him that over the past week, they'd never have to mess with credit card fraud again. "Yes, Dean. I'm fine." He pushes himself up off the bed and grabs his coat. "You ready?"

Dean slams the laptop shut and grabs his coat. "Yep. How's the leg? You need a piggy-back ride or anything?"

Sam glares.

"What? You used to love it when you were a kid."

Sam waits until Dean's walking out of the room then jumps on his back, just for the hell of it.

* * *

><p>The doctor's office is cold and smells like urine. Sam doesn't want to know why. He avoids touching any part of the exam table that's not covered with the long strip of paper. The doctor (who looks like he moonlights as Santa Claus) is standing at a counter, looking over Sam's chart.<p>

"Well, Sam, your INR is good. 2.8. We want it between 2.0 and 3.0. You can stop the Lovenox injections. Keep taking 10 mg of Coumadin a day. Since you haven't been on it long, I want to see you back for another INR check in a week. As long as that's good, you can come back once a month to have it checked."

They probably won't be here in a month or even in a week, but Sam nods anyways. Good news is rare. He'll take it. "That's great."

"How are you feeling? Any chest pain? Coughing? Trouble breathing?"

"No," Sam says. "I feel fine."

The doctor nods but puts his stethoscope in his ears anyway, and Sam can't help but notice that the hair in his ears is just as white as the hair in his beard and on his head. Gross. "Deep breaths," the doctor says. Sam obeys. "Sounds good." The stethoscope goes back around his neck. "How's the leg feel?"

Sam pulls the pant leg of his jeans up to his knee. "Not bad," he says, all casual and shit. Like it doesn't hurt.

"He can't straighten his leg all the way," Dean comments from the extra chair in the room. "Is that normal?"

The doctor checks the pulse in Sam's foot before answering. "Given that the clot is behind the knee, that makes sense. It will get better. You just have to give it time."

Everyone keeps saying that, but Sam's getting frustrated. They've spent almost the whole week holed up in the motel room. They've done enough research that they think they know what they're hunting now, but it's a two-person job. Even Dean's not stupid enough to try this one on his own. "When can I get back to my normal activities? Like working out?" Because yeah, that almost covers what he considers to be normal activities. Almost.

The doctor finishes examining Sam's leg. "Your blood is thin now. You're young and healthy. I'm not too worried about the clot breaking off and becoming a PE. Just take it slow at first. Your leg is going to swell and be painful for a while, so non-weight-bearing activities like swimming or biking will be best."

"Are you sure he shouldn't take another week or two off?" Dean asks.

"Dean," Sam protests, because this Santa doppelganger is about to lift his restrictions and really, why does Dean want to prevent that?

"Exercise is good. It gets the blood flowing. Just do what you can with the pain and swelling, take your Coumadin, and be careful not to get hurt. Okay?"

Restrictions lifted. Mission accomplished.

They thank the doctor and head out of the office, neglecting to make a follow-up appointment that they won't keep. Sam tries not to limp and wills the blood clot to stay in his leg with every step because it's habit now.

"So?" Sam asks when they're in the car. "Tonight."

"No." Dean slams the car door. "You heard what the doctor said. Be careful. Hunting some new fucking brand of monster that we've never heard of before is not being careful."

"Dean…"

"No. We know the bastard's not going to kill anyone until the next new moon, which is still 13 days away."

"Eleven days away," Sam corrects softly.

"Whatever. We'll wait until you can walk without fucking limping. We'll do more research. We'll wait until you're not going to die."

Sam stares hard out the window and works his jaw. "Thought we agreed this thing in my leg isn't going to kill me?"

Out of the corner of his eye, Sam sees Dean pinch the bridge of his nose. Hard. "Shit, Sam," he breathes. "We're waiting, okay? A few more days. Just a few more days."

Sam sighs and Dean turns up the radio and drives.

* * *

><p>"I'll have the grilled chicken with the cauliflower mash," Sam says, handing his menu to the waitress.<p>

"Oh no you don't." Dean is sitting with one of the Coumadin pamphlets in his hand. "No cauliflower."

"They said green vegetables, Dean. Last time I checked, cauliflower wasn't green."

Dean holds up the pamphlet. "Don't care. It's on the list."

Sam sighs and turns to the waitress. "I'll have the coleslaw instead."

"Cabbage," Dean says. "That's a negative."

"Potato salad?" Sam asks, looking to Dean instead of the waitress.

"Apparently mayonnaise is also high in vitamin K."

Sam wants to rip the fucking pamphlet right out of Dean's hands, but he doesn't. He takes a deep breath. "I can have vitamin K. I just have to eat it consistently."

"Yeah? And exactly how the hell do you eat mayonnaise consistently?"

Sam sighs and forces a smile at the waitress. "Burger. No lettuce. No mayo. And fries."

Dean grins like a kid in a candy shop. "Atta boy!"

* * *

><p>They're doing more fucking research when Sam's phone vibrates in his pocket. The number on the screen is not familiar. "I'll be right back," he says, and gets a grunt in response.<p>

"Mr. Rodriguez?" a semi-familiar voice comes across the line.

"Yes?"

"This is Dr. Khan calling from Madison Memorial Hospital."

Shit. His blood tests. Sam had almost forgotten about those. Almost.

"How are you feeling?" Dr. Khan asks.

Sam doesn't answer the question. "You got the results of my blood tests?"

Dr. Khan hesitates. "Yes, and we discovered that you have a genetic blood clotting disorder called Factor V Leiden. The proteins in your blood don't allow your body to break down and prevent clots like it should. That, combined with the long hours you spent in the car probably caused your DVT."

Shit. Sam clears his throat. "Okay. So, what does that mean, exactly? What now?"

"It means that you're going to be on Coumadin for longer than 6 months. You'll need to be on it the rest of your life."

_Shit_.

"I realize that can sound intimidating when you're so young and otherwise healthy, but the condition is manageable. As long as you stay on Coumadin, you shouldn't have any more problems with blood clots."

Sam hears the inverse: _If you don't stay on Coumadin, you're going to have more problems with blood clots._

The doctor wants the name and number of Sam's primary care physician so he can fax the results over, but Sam just hangs up. The only primary care physician he's ever had is Dean, stitching up wounds and doling out cold medication and pushing back sweaty bangs while he pukes.

Fuck if this is going to change that. He'll take a pill a day for the rest of his life and avoid salads and stop playing with knives and he'll be fine. He won't die and he'll be just fucking fine.

Back in the library, Dean looks up from the book he's reading. "Who was that?"

"Someone selling something."

Dean rubs his eyes. "Took a while."

Sam shrugs. "They kept trying to make me an offer I couldn't refuse."

* * *

><p>Four days later, Dean agrees it's time to hunt. Sam's limping less and breathing fine. They both passed restless a long damn time ago. They need to put this hunt, this town, and everything that goes with it behind them.<p>

They load up on their usual weapons. Sam takes the guns. Dean takes the knives. Because apparently Sam needs the safety scissors with the rounded points from now on. They also take a shit-ton of copper, because that's what they've discovered through all of their research. If anything's going to take this beast down for good, it's going to be copper.

They head into the lair, armed with knowledge and weapons and each other and they fight. It's definitely a two-person job. Even then the son of a bitch almost gets away. But in the end, they take care of it because they're Sam and Dean and they always take care of it.

"Shit," Dean says, breathless in the aftermath. He touches his sluggishly bleeding lip.

"Yeah. You okay?"

"I'm fine. You?"

Sam considers. Now that the adrenaline is wearing off, his leg is starting to throb, but it's tolerable. He's breathing okay. "Yeah. I'm good."

Dean nods. "Good."

And Sam knows what he's really saying. Good, he's alive. Good, they made it through a hunt even with this blood clot shit. Good, they can do this.

"Think there might be something in Ohio," Dean says. "Want to go check it out?"

* * *

><p>Dean stops driving every two hours to make Sam walk around, get the blood flowing through his veins again. Other than that, it seems normal.<p>

Simple.

But it only seems normal and it's never that simple.

They've crashed out in a motel in Ohio for a few hours, and Sam wakes up _sore_. He climbs out of bed and it hurts. Not just the familiar throbbing of his leg. His whole body.

In the bathroom, the harsh fluorescent bulbs buzz with effort. Sam catches a glimpse of himself in the mirror and stops dead in his tracks. Bruises cover his arms and torso.

Some of them he remembers getting, like the one where the son of a bitch whacked him across the chest with a tree limb. But most of the bruises are mysteries. They're big and purple and blue and fucking _black_ and they hurt and _he doesn't know where they came from_.

Sam closes his eyes and realizes that he hoped the doctors were wrong. Yeah, they said he'd bruise and he'd bleed, but on some level he thought he would be the exception to the rule.

Out of morbid curiosity, Sam takes a razor from his bag. With a flick of his wrist, he makes a quick, tiny cut in the skin on the back of his arm. Blood pools almost instantly, then starts dripping into the sink. It shouldn't be bleeding this much, but it is. It doesn't stop, doesn't stop, doesn't stop.

Sam is not immune to this shit.

The sound of Dean moving around snaps him out of his trance, and he rinses the cut in a swirl of pink. He presses toilet paper against the cut and it doesn't stop, doesn't stop, but then it finally does.

Sam flushes the bloody toilet paper, pulls on a long sleeve shirt, and pretends like he's still compatible with hunting.


	4. Chapter 4

**AN:** If blood grosses you out, you might want to skip this chapter. Consider yourself warned.

"So, it's been longer than a week since your last doctor's appointment," Dean says.

They're walking back to the car after interviewing the former owners of one extremely haunted house. Sam's still limping more than he'd like, but he can keep up. His dress shoe fit on his right foot this morning, so that's a plus.

"And?" Sam asks, loosening the knot in his tie.

"Think we should find a doctor in this town? Get your INR checked?"

"Nah."

"The last doctor said to have it checked in another week."

Sam breathes out a laugh. "And we started following doctors' orders and keeping regular appointments when, exactly?"

Dean's response is lighting fast. "When you were diagnosed with something that could kill you, Sam. That's when."

They get in the car. "You can't keep doing that, you know," Sam says. He rubs absently at his calf.

"Keep doing what?"

"Keep telling me this thing isn't going to kill me, then change your mind and tell me it is just because you want me to go to the doctor or rest. That's a low blow, man."

Dean puts the car in reverse and doesn't say a word. The steering wheel clenched tightly in his fists and the way his teeth are grinding together say it all.

"Look, I'm taking the Coumadin every day. My INR is fine. It was fine last week and it's fine this week."

"Yeah, like you can really tell that."

"I can," Sam says. "I feel the same as I did last week. My leg is getting better. My blood feels thin." This is 100% bullshit, but they're figuring out how to define this new version of normal, and Sam's not about to let the definition include wasting time in doctors' offices and allowing some number from a blood test to dictate his life.

Dean turns off the radio. He removes one hand from the wheel and places it firmly in the middle of Sam's chest. "Deep breath."

This is Dean's new thing. It seems to calm him down and assure him that Sam's not going to die right this fucking minute, so Sam's okay with it. He takes the deepest breath he can, letting Dean's hand rise and fall, letting him feel that he's breathing fine and there aren't any crackles and the clot is still very much in his leg.

"You're good, Sammy," Dean says as he claps his brother firmly on the chest. Sam grunts in response. "But a doctor soon, yeah? After we take care of this haunted house?"

"Yeah. Sure."

"Good. You know, maybe I should invest in a stethoscope."

Sam smiles and turns the radio back on. "You wouldn't know what to do with a stethoscope if one hit you in the face."

"Yes, I would. I'd put the ear pieces into your ears while you slept and fart into the other end. It would be epic."

Sam's head falls back against the seat as he laughs. "You would, wouldn't you?"

"Absolutely. Or I'd belch the alphabet and make you listen. Surround sound." When he turns to Sam, Dean is smiling. It's a good sight. "Hey, I'm starving. Want to get some food?"

This. This right here is the only definition of normal Sam wants.

The restaurant's waitress places one plate in front of Dean and in the other in front of Sam. "Enjoy, gentlemen," she says. "Let me know if there's anything else I can get for you."

"Hold it," Dean says, stopping her in her tracks. He points to Sam's plate. "What the hell is that?"

"Dean…"Sam warns.

"A grilled chicken sandwich with a side of vegetables. Just like he ordered."

"I thought you said the vegetable of the day was carrots," Dean says.

"Yeah. Peas and carrots."

"Do you know how much vitamin K is in a serving of peas?" Dean growls.

"Probably a lot," the poor waitress says with a smile, like it's a good thing.

"Exactly. And…" Dean trails off as he looks at Sam's sandwich. He knocks off the bun and points. "And what the hell is that?"

"Spinach," she says proudly. "The sandwich is one of our healthy menu items, so we put spinach on it instead of iceberg lettuce."

"Dean, it's fine," Sam says. "I'll take the spinach off the sandwich and I won't eat…"

"No," Dean interrupts. He picks up the plate and shoves it forcefully back at the waitress, who is now wide-eyed. A few peas roll off the plate and fall to the ground. "Make it again. And if I see so much as a ispeck/i of anything green on the plate, I swear to God, I'll…"

This time it's Sam's turn to interrupt. "That's enough, Dean." Sam smiles gently at the waitress. "If you're going to put spinach on it, you should probably say that on the menu."

She nods quickly. When she takes the plate, a few more peas fall to the ground. "Right. Okay. I'll…I'll tell my boss that. Sorry. Be right back."

"Fucking idiots," Dean says once she's gone, before shoving a few French fries into his mouth.

"You're going to have to relax about the vitamin K stuff, you know. You can't keep scaring waitresses and changing my dinner orders forever."

"Not forever. Just for the next 3-6 months."

Sam stares hard at the table and crumples his straw wrapper into a tiny ball. "Right."

Then he forces a smile and steals a fry from Dean's plate.

They take care of the haunted house a few days later. Unfortunately, a glass window is shattered in the process. Sam holds up his arms and tries to run, but he's not fast enough.

It's bad. He squeezes his left hand around his right elbow, hoping to fend off the worst of the bleeding.

"Sam? You okay?" Dean asks as he runs into the room.

"Yeah. Fine. Give me your shirt."

Dean tears off his shirt without a single lecturing word about how Sam should have been more careful.

"Tie it tight," Sam says, holding out his bleeding arm.

Dean does. "Too tight?" But he doesn't wait for an answer because right now "too tight" probably doesn't exist. "Come on. Let's get out of here."

They're in the car and heading for the motel in record time. The blood is seeping through Dean's shirt. Shit. This is bad.

When they get to the motel, Dean guides Sam straight to the bathroom with their first aid kit in hand. "Let me see."

That means showing Dean how much he's bleeding and how many bruises he has. This is going to be bad. Sam carefully removes Dean's ruined shirt. He carefully pulls his arm out of his own cut-up, bloody sleeve.

Dean is already running washcloths under the faucet. "Shit, that's a lot of blood. Gonna need stitches."

"Yeah." While Dean cleans the wound, Sam uses his other hand to pull out a needle and sutures.

"I'd give you a shot of whiskey," Dean says as he picks up the needle, "but…"

No alcohol. Sam tenses all of his muscles. Grits his teeth. Holds perfectly still, and says, "Just get it over with."

It hurts a hell of a lot even with Dean's quick, practiced motions. Sam is almost shaking with pain by the time Dean pats a clean washcloth to his arm and says, "Okay. Okay. Done."

Sam gasps out a breath and leans his elbows on the counter. "Fuck," he whispers. He stands there for a minute, catching his breath.

Dean gives him pain pills and water. "So," he says as he rubs antibiotic ointment onto the wound, "these bruises."

Sam shivers and closes his eyes. "The doctors said I'm going to bruise easily, Dean."

Dean rips a piece of medical tape from a roll. "Are you bruised like that anywhere else?"

"My leg. From the last hunt." The half-truth falls easily from his lips. He glances at Dean's reflection in the mirror. "But come on, how many times have you gotten banged up on a hunt, right? And if you had been hit with that window, it would be me doing the sutures right now."

"But it wasn't me," Dean says softly. He finishes taping a piece of gauze in place.

When Sam pushes away from the counter, Dean puts a hand on his chest. Sam takes a deep breath without being told what to do. It calms him almost as much as it does Dean.

"How's your leg?" Dean asks before taking his hand away.

"It's fine. I'm fine."

"We need to get your INR checked. Might be too high."

"Better than too low. It's Friday evening. No doctors open. We'll go on Monday."

Dean hesitates and nods.

But the air around them feels unstable. Like they're just waiting for a storm to hit.

"I really don't think it's just an angry spirit," Sam says, pulling up a search engine on his laptop. It's Sunday. Dean spent most of Saturday checking Sam's arm constantly like it was going to start bleeding spontaneously. But it's healing, and so are the bruises, and they're getting past it. Like normal.

"No? Why not?"

"I don't know. It just seems too random. Too many victims don't fit the patterns, either with where they were killed, or if they knew…" Sam trails off when he notices blood on the desk. A lot of blood. He checks his arm and his hands but doesn't see anything. Then he puts a hand up to his nose. It comes back covered in blood. Shit.

He stands and tries to get to the bathroom before Dean sees, but fails.

"Sam? Is that blood?"

Sam rushes into the bathroom and grabs a handful of tissues, shoving them up against his nose. When he looks in the mirror, he sees fear in his eyes and blood down the front of his shirt.

"What the hell?" Dean asks.

"Nosebleed," Sam says, but the end of the word is cut off when he starts choking. He coughs and splatters the sink with blood.

"All right," Dean says, clapping him on the back and tilting his head forward over the sink. "It's okay." Dean takes the soaked tissues from Sam and gives him a washcloth to use instead. Dean pinches his nose hard, and Sam knows he's going to have a bruise.

After a few minutes, Dean says, "Okay. I'm going to let go. See if it stopped yet. Okay?"

Sam nods. The washcloth that used to be white is now black-red. Sam pulls it away from his face and tosses it in the sink. Dean has a hand-towel ready, just in case. When Dean lets go, blood instantly gushes all over the place.

"Shit," Dean says, pinching Sam's nose hard again.

Sam holds the hand towel to his nose and tries not to panic. It's just a nosebleed. It will stop. But when they try again a few minutes later, it's still bleeding.

Sam has a serious case of déjà vu. Different day. Different hotel room. Different wound. But still Dean and Sam in a bathroom, up against Sam's blood.

Fuck.

After a while, Sam starts sweating. His heart pounds faster than it should. First aid training runs through his brain. Hypovolemic shock. Stage 2. His nose needs to stop bleeding. Now.

As if reading his mind, the fingers of Dean's free hand find Sam's jugular. "Talk to me, Sam. How are you feeling?"

"Heart's pounding," Sam mumbles into the towel. He feels Dean's hand return to his back. "Sweating."

"Yeah. I'm thinking we get you to a hospital now."

"No," Sam says. "It'll stop." It will. It has to. Dean says something in response, but Sam doesn't hear it. He's too busy trying to stop the bleeding and slow his pulse and breathe and stay upright.

This is bad. This is so fucking bad bad.

And that's the last thing Sam thinks.


	5. Chapter 5

**AN:** This took forever and it's short. But I hope you like it anyway…

* * *

><p>Sam wakes one sense at a time.<p>

First, he smells blood, sharp and metallic.

It smells like death.

The second time he wakes, he feels Dean's hand on his chest, rising and falling with each inhale and exhale.

He's alive.

Next, he hears an unfamiliar voice talking about things like blood loss and organ system failure.

He's alive, but it was close.

When he wakes enough to open his eyes, he sees words written all over cloudy green eyes and wet cheeks.

I thought I lost you.

Those tears follow Sam into his dreams.

The next time he wakes, he's alert. Clear. Dean is feeding him ice chips that are cold and taste like heaven, but Sam's alive.

Sam asks, "What happened?"

Dean spoons another ice chip out of the cup and into Sam's mouth. When he speaks, his voice is rough. "Your INR was more than 5 times what it should have been. You got a nosebleed. Lost a lot of blood. Your heart stopped for a minute."

Sam closes his eyes as his mind tries to process the fact that he died. He died. He opens his mouth and Dean slides another ice chip in.

"They did a bunch of tests to make sure your insides aren't as bruised and bloody as your outsides. They pumped you full of blood and fluids and – get this – vitamin K. Apparently it's the antidote. I should have let you eat a fucking salad."

The ice chip finishes melting in Sam's mouth as he opens his eyes. "Not your fault."

Dean's eyes flick down to Sam's chest. "How are you feeling?" he asks, as if Sam hasn't said anything at all.

"Tired."

Dean sets the cup down and puts a hand flat on Sam's chest. It's more than just this thing they do to check for a pulmonary embolism now. It's more than just keeping them calm. It's Sam, breathing and heart beating, and alive.

Dean says, "Sleep," and keeps his hand right where it's at.

Sam lets himself fall.

* * *

><p>"Your INR is still at 4.8. Too high, but not critical." The doctor, whose name they didn't even bother to learn, flips through Sam's chart. "No Coumadin tonight. Tomorrow we'll start you back on 5 mg per day. But you need to have your INR checked more regularly. It can't get that high again, okay?"<p>

"Yes sir," Sam says.

The doctor smiles like he's fixed everything, then leaves Sam and Dean alone.

"Can we get out of here?" Sam asks.

Dean rubs a hand over his chin. It's been too long since he's shaved. "You heard the man. They want to keep you another night or two."

"I did hear the man. He said not critical. Which means we can get out of here."

When Dean stands, it's with enough force that the chair is pushed back a few inches. Sam watches as he pinches the bridge of his nose and paces and looks everywhere but at Sam and doesn't say a word.

"What, Dean? You hate hospitals. You want to get out of here as much as I do. Why are you acting like this."

"Because you died," Dean bites out. Sam flinches even though Dean's standing all the way at the foot of the bed. He's clutching the railing so hard that his knuckles are white. "Your heart stopped, Sam. This isn't a goddamn broken leg or fucking pneumonia. You died."

This isn't what Sam wants. None of it. Not lying in the hospital bed. Not watching Dean fall apart. Not thinking about the fact that this thing he has to deal with for the rest of his damn life already tried to kill him. Not thinking about the secret he's keeping.

"Hey," Sam says softly.

It takes a minute before Dean lifts his gaze. His eyes look like anger, but it's a thin mask over fear.

"Come here."

Very slowly, Dean lets go and walks to the side of the bed. Sam grabs Dean's hand. It's warm and rough. He pushes Dean's palm against his sternum and holds his own hand over the top. Then he breathes. Slow. Deep. Easy. "Feel that?" he asks, looking Dean in the eyes. "I'm okay. I'm fine. Everything's going to be fine."

They stay like that for a long time, until Dean gives an almost imperceptible nod.

Sam lets his head flop back against the pillow as he releases Dean's hand. "Let's just go, okay?"

"Go where? Don't say on a hunt. If you say on a fucking hunt, I will fucking kill you."

Though the words are powerful, they sound desperate. They mean they're going to have to take baby steps back towards normal, and Sam's going to have to be okay with that. He starts picking at the tape holding his IV tubing in place. "Florida."

Dean's eyebrows lift as he opens a cabinet and takes out gauze and tape. "Florida?"

Sam shrugs. "Happiest place on Earth, right?"

"You want to go to Disney World?"

Sam shrugs again. "Disney. Miami. New York City. Vegas. Seattle. Don't care. Not here." Anywhere, as long as they can put all of this behind them.

With careful hands, Dean finishes removing the tape from Sam's arm. The skin there is already bruising. Many of Sam's bruises are starting to fade, but not this one. This one's too fresh.

"Wherever we go, we're going to stop every two hours. Get out of the car. Walk around."

"I don't think I have to worry about any more clots right now." Dean glances up from his work, and it's a look Sam does not want to mess with. "But yeah. Okay. Every two hours."

"And we find a doctor. Get your INR checked. Take better care of this shit."

Sam nods. "Yeah. Fine."

Dean pulls the IV out and presses gauze to the wound. "Sorry," he says when Sam winces. "Hold that there."

Sam holds the gauze tight and watches as Dean takes out a set of clothes. Not the clothes Sam wore, unconscious, into the hospital. They won't talk about the fact that those were destroyed.

"Want to get changed?"

"Yeah." But when he lets up on the gauze, blood drips down his arm. "Shit," he mutters.

Dean is there in an instant with more gauze. This time he doesn't apologize for pressing too hard on Sam's bruise. When Sam looks up, Dean looks panicked, like a pull on the tiniest thread will unravel everything.

"It's okay," Sam says. "It's going to stop."

"Shit, Sam." He presses down hard and shakes his head harder. "No. This is a bad idea. I'll go get a nurse..."

"It will stop," Sam interrupts. It's going to stop. It has to stop. And finally it does. Sam sighs in relief and lets Dean tape down fresh gauze.

When he's finished, Dean picks up Sam's clothes again. He clutches them against his chest. "You're sure about this?"

"Positive. I need to get out of here." Sam doesn't say it, but Dean needs to get out of here, too. Needs to wipe that look of panic and fear and my brother died off his face. "Help me get dressed."

By the time he's ready to go, Sam is exhausted. He just needs to make it out to the car. Then he can sleep. With Dean's help, Sam limps his way out of the hospital. Even though his blood was thin enough to stop his heart, the clot in his leg still fucking hurts.

"You good?" Dean asks as they pile into the car. It smells like leather and gunpowder and home.

"Yeah."

"Happiest place on Earth?" Dean asks as he starts the car.

"Anywhere but here."

Dean shakes his head, but he's smiling a little. He drives.

When Sam looks in the rearview mirror, the hospital is long gone. He breathes and feels his heart beat and is alive.

Simple.


End file.
